Individual
LEO JOHN-PAUL SHANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
1125 FULTON ST, BROOKLYN, NY 11238-2669
(917) 659-8673
Mailing address
1125 FULTON ST, BROOKLYN, NY 11238-2669
(017) 659-8673
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
32430
NY
Other
Enumeration date
04/16/2025
Last updated
04/16/2025
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